DIABETIC KETOACIDOSIS

1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis?

A. Positive Ketones in the urine
B. Oliguria
C. Polydipsia
D. Abdominal Pain

2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous

fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and
then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25,
Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing
intervention to perform next?

A. Start the IV fluids and administer the insulin bolus and drip as ordered
B. Hold the insulin and notify the doctor of the potassium level of 2.5
C. Hold IV fluids and administer insulin as ordered
D. Recheck the glucose level

3. Which patient is MOST likely to develop Diabetic Ketoacidosis?

A. A 25 year old female newly diagnosed with Cushing's Disease taking

glucocorticoids.
B. A 36 year old male with diabetes mellitus who has been unable to eat the
past 2 days due to a gastrointestinal illness and has been unable to take
insulin.
C. A 35 year old female newly diagnosed with Type 2 diabetes
D. None of the options are correct.

4. Which of the following statements are INCORRECT about Diabetic Ketoacidoisis?

A. Extreme Hyperglycemia that presents with blood glucose >600 mg/dL

B. Ketones are present in the urine
C. Metabolic acidosis is present with Kussmaul breathing
D. Potassium levels should be at least 3.3 or higher during treatment of DKA with
insulin therapy

5. True or False: When priming the tubing for an Insulin infusion it is best practice to
waste 50cc to 100cc of insulin prior to starting the infusion because insulin absorbs into
the plastic lining of the tubing.
 A. True
B. False

6. You are providing care to a patient experiencing diabetic ketoacidosis. The patient is
on an insulin drip and their current glucose level is 300. In addition to this, the patient
also has 5% Dextrose 0.45% NS infusing in the right antecubital vein. Which of the
following patient signs/symptoms causes concern?

A. Patient complains of thirst.

B. Patient has a potassium level of 2.3
C. Patient's skin and mucous membranes are dry.
D. Patient is nauseous.

7. . What type of insulin do you expect the doctor to order for treatment of DKA?

A. IV Novolog
B. IV Levemir
C. IV NPH
D. IV Regular Insulin

8 A patient diagnosed with diabetes mellitus is being discharged home and you are
teaching them about preventing DKA. What statement by the patient demonstrates they
understood your teaching about this condition?

A. "I should not be alarmed if ketones are present in my urine because this is
expected during illness."
B. "It is normal for my blood sugar to be 250-350 mg/dL while I'm sick."
C. "I will hold off taking my insulin while I'm sick."
D. "It is important I check my blood glucose every 3-4 hours when I'm
sick and consume liquids."